Gastrointestinal distress, State and Trait anxiety, and dietary intake among college students during the COVID-19 pandemic.

OBJECTIVE: This study examined the impact of State and Trait anxiety and dietary intake on college students' gastrointestinal symptoms during the COVID-19 pandemic. PARTICIPANTS: A total of 455 students, aged 18-23, from two residential colleges in the midwestern United States participated in the study during April 2021. METHODS: An online questionnaire that included the National Cancer Institute Dietary Screener, State-Trait Inventory for Cognitive and Somatic Anxiety, and an adapted version of the Gastrointestinal Symptoms Questionnaire was used. Stepwise multiple regression analyses and Spearman rho correlation coefficients were used to analyze the data. RESULTS: High rates of State-somatic, State-cognitive, and Trait-somatic anxiety were present in our study population. These anxiety subscales and dietary intake predicted 26% and 3.8% of the GI symptoms variance, respectively. CONCLUSION: State-anxiety and Trait-somatic anxiety are large factors in predicting GI symptoms compared to dietary intake. College students could seek anxiety-reducing techniques to ease GI symptoms.

Insulin analogs versus human insulin in the treatment of patients with diabetic ketoacidosis: a randomized controlled trial.

OBJECTIVE: To compare the safety and efficacy of insulin analogs and human insulins both during acute intravenous treatment and during the transition to subcutaneous insulin in patients with diabetic ketoacidosis (DKA). RESEARCH DESIGN AND METHODS: In a controlled multicenter and open-label trial, we randomly assigned patients with DKA to receive intravenous treatment with regular or glulisine insulin until resolution of DKA. After resolution of ketoacidosis, patients treated with intravenous regular insulin were transitioned to subcutaneous NPH and regular insulin twice daily (n = 34). Patients treated with intravenous glulisine insulin were transitioned to subcutaneous glargine once daily and glulisine before meals (n = 34). RESULTS: There were no differences in the mean duration of treatment or in the amount of insulin infusion until resolution of DKA between intravenous treatment with regular and glulisine insulin. After transition to subcutaneous insulin, there were no differences in mean daily blood glucose levels, but patients treated with NPH and regular insulin had a higher rate of hypoglycemia (blood glucose <70 mg/dl). Fourteen patients (41%) treated with NPH and regular insulin had 26 episodes of hypoglycemia and 5 patients (15%) in the glargine and glulisine group had 8 episodes of hypoglycemia (P = 0.03). CONCLUSIONS: Regular and glulisine insulin are equally effective during the acute treatment of DKA. A transition to subcutaneous glargine and glulisine after resolution of DKA resulted in similar glycemic control but in a lower rate of hypoglycemia than with NPH and regular insulin. Thus, a basal bolus regimen with glargine and glulisine is safer and should be preferred over NPH and regular insulin after the resolution of DKA.